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EDI 142

EDI 142 Product Service Claim:

EDI 142 Format:

ISA*00*          *00*          *01*1234567890     *01*999999999      *120126*1211*U*00401*000000475*0*P*\
GS*WA*1234567890     *999999999      *20120126*1211*1*T*004010
ST*142*0001
BGN*00*Reference Identification*20120227*1251*01*Reference Identification*01*1*00
N9*01*Reference Identification*Free-form Description*20120227*1251*01*01\Reference Identification\01\Reference Identification\01\Reference Identification
N1*01*Name*1*Identification Code*01*01
N2*Name*Name
N3*Address Information*Address Information
N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier
REF*01*Reference Identification*Description*01\Reference Identification\01\Reference Identification\01\Reference Identification
PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe
LX*27
N9*01*Reference Identification*Free-form Description*20120227*125111*01*01\Reference Identification\01\Reference Identification\01\Reference Identification
MSG*Free-Form Message Text*AA*2
LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID
PID*F*01*10*Product Desc*Description*1S*Source Subquali*N*LAN
LOC*01*Reference Identification*Description*Reference Identification*Catego*01*Reference Identification*Description*Reference Identification*1835216312231861206*01\113351419467301\126220871\01\13922107523012\3155047\01\265643156862\8497187862\01\28919599\19648\01\2823925483\258661*3989143*01\41802048985\9945619\01\173322922\308\01\300393\1636724\01\111043543\125\01\822110420307283\1291*3*01\8042240961552\376119\01\506739354144\259\01\256745107\1\01\292660373\3115442532\01\58\32073061*128193037529189226*01\22655167\2232\01\1309714\1604128\01\1\29739188\01\23659\631812939\01\2490727\2844*8540320215199*01\490855153760222\1\01\783\788832\01\5595807247142\205\01\140632917225213\180072371\01\262271813\189652*87551*01\22690189\10796293\01\99541075\32516167\01\1235012765279\1842212483\01\293808708583\185529675\01\754\3025353*01*Reference Identification*Description
QTY*01*179038665*01\1288412\98\01\18388\41\01\239221\2\01\2548\1\01\17592963531342\445
DTM*001*20120227*12511100*01*CC*Date Time Period
REF*01*Reference Identification*Description*01\Reference Identification\01\Reference Identification\01\Reference Identification
PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe
PSC*AC*AF*AF*Reference Identification*01*Contract Number*01\193013249017\136691883\01\35274\16389\01\105\154091\01\1759949412\1\01\214\1430632*5*001*20120227*20120227*01\1284525\5537\01\413991852\8565244411\01\22251172\22761\01\12\4\01\119813649\1110872*2387272727521172*111*6954129601857794612*1*239*10*Source Subquali*01*AC*Description*1646291*N*E
SSS*A*10*AC*Service Marks and Numbers*713229905*5942237*Description*26*Source Subquali
LM*10*Source Subquali
LQ*0*Industry Code
N1*01*Name*1*Identification Code*01*01
N2*Name*Name
N3*Address Information*Address Information
N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier
N9*01*Reference Identification*Free-form Description*20120227*12511100*01*01\Reference Identification\01\Reference Identification\01\Reference Identification
PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe
PRR*Assigned Identificat*10*Source Subquali*BRK*Description*10*Source Subquali*A*10*Source Subquali*1
LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID
LOC*01*Reference Identification*Description*Reference Identification*Catego*01*Reference Identification*Description*Reference Identification*192662773610362237*01\46801088914002\196182605\01\2511146399\84\01\203343082489\30751\01\2913\996596\01\1479\303606*41778137276851797011*01\179266442\243013\01\15\306032663\01\1024323\29\01\774819740104162\186103868\01\179\26*421913348326552804*01\158\1073493\01\280961852630967\265314024\01\518718\21783149\01\284411100017\1943719404\01\12140281551852\174011*25203121*01\3\14396274\01\31302343132381\16241154\01\4\2194328\01\246531\172752401\01\7107222\2*1*01\1669013932545\10822658\01\27616\2\01\295638654282711\9424189\01\241571911\7691472356\01\15\317*1247219396228768465*01\102\28883258\01\143130356166\257434\01\73572021519\5541309\01\16607\19131306\01\176093080517\1416546472*01*Reference Identification*Description
QTY*01*13312645516*01\43433124\12\01\2175956811631\154\01\1081\2088\01\201\984\01\2628225763\193
DTM*001*20120227*125111*01*CC*Date Time Period
MSG*Free-Form Message Text*AA*222
RC*A1*Product/Service ID*Name*10*Source Subquali*Cas*Description*Free-Form Message Text*N
PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe
PSC*AC*AF*AF*Reference Identification*01*Contract Number*01\147612\641826753\01\25091\24\01\1963698522\21604\01\2282925444\1\01\1\135771*64*001*20120227*20120227*01\2\29789105\01\286332191\138762707\01\12345534248\22236\01\54\14252\01\8\188*153551*163411021696248965*15*1*32128234*10*Source Subquali*01*AC*Description*1313428453*N*E
SSS*A*10*AC*Service Marks and Numbers*46786794258777*3221*Description*91792339722067*Source Subquali
CID*1*01*10*Product Desc*Description*Source Subquali*N
TMD*01*10*Product Desc*01*01*Description*20120227*Reference Identification*Source Subquali
MEA*9L*1*2601139731*01\308422374418752\2107457\01\124731\1189307422\01\541111153\900191\01\21833299\28272845\01\279\113*5738321*25152859*01**1S*BM
DTM*001*20120227*12511100*01*CC*Date Time Period
LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID
REP*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*10*Source Subquali*AL*Description*10*Source Subquali*DAP*A1*Product/Service ID*AL*Description*10*Source Subquali*Reference Identification*Auth
REF*01*Reference Identification*Description*01\Reference Identification\01\Reference Identification\01\Reference Identification
N1*01*Name*1*Identification Code*01*01
PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe
RC*A1*Product/Service ID*Name*10*Source Subquali*Cas*Description*Free-Form Message Text*N
DTM*001*20120227*1251110*01*CC*Date Time Period
LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID
ITA*A*10*AC*01*Allowance or Cha*189*843328*1*1*14050337031368*01*22451*Description*002*Source Subquali*A*01
MSG*Free-Form Message Text*AA*212023699
PRT*EXC*10*Source Subquali*N
LM*10*Source Subquali
LQ*0*Industry Code
MEA*9L*1*17560174*01\239922802\235412\01\85801\2\01\3193128148\70463\01\186722\197172\01\783\28852*24*26456*01**1S*BM
DTM*001*20120227*125112*01*CC*Date Time Period
LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID
IT1*Assigned Identificat*17*01*15330229*AA*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID
LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID
N1*01*Name*1*Identification Code*01*01
N9*01*Reference Identification*Free-form Description*20120227*1251*01*01\Reference Identification\01\Reference Identification\01\Reference Identification
PRT*EXC*10*Source Subquali*N
DTM*001*20120227*12511200*01*CC*Date Time Period
ITA*A*10*AC*01*Allowance or Cha*177793*159294425*1*35*306842*01*2056626*Description*002*Source Subquali*A*01
CUR*01*CUR*295729412*01*CUR*IMF*001*20120227*1251120*001*20120227*125112*001*20120227*12511200*001*20120227*12511200*001*20120227*125112
AMT*1*2539*C
TXI*AA*3223*3133314*CD*Tax Jurisd*0*A*370719*Tax Identification N*Assigned Identificat
CUR*01*CUR*15605*01*CUR*IMF*001*20120227*1251120*001*20120227*1251120*001*20120227*125112*001*20120227*1251120*001*20120227*12511200
TDS*103*1050562*430652*2012678
TXI*AA*5766104*1015*CD*Tax Jurisd*0*A*108*Tax Identification N*Assigned Identificat
CUR*01*CUR*2794*01*CUR*IMF*001*20120227*1251*001*20120227*125112*001*20120227*1251*001*20120227*1251*001*20120227*1251
SE*74*0001
GE*1*1
IEA*1*000000475

EDI 142 Specification:

This X12 Transaction Set contains the format and establishes the data contents of the Product Service Claim Transaction Set (142) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to transmit the servicing organization, claimant, manufacturer, seller, and purchaser of the product.

It can specify the product's current usage, date the product was sold, delivered, and placed in service as well as identify product model and serial numbers and serial numbers of any subassemblies. It can specify a malfunction or recall condition, service performed, labor, parts, and any other associated costs. It can show the costs of the repair and the date service was requested and when it was available to be placed back in service.

Sources
Accredited Standards Committee X12. ASC X12 Standard [Table Data].
Data Interchange Standards Association, Inc., Falls Church, VA.


Page Title: Learn about the EDI 142 Product Service Claim